title: Fundamental radiological and geometric performance of two types of proton beam modulated discrete scanning systems.
abstract: OBJECTIVE
  The purpose of this investigation was to compare and contrast the measured fundamental properties of two new types of modulated proton scanning systems. This provides a basis for clinical expectations based on the scanned beam quality and a benchmark for computational models. Because the relatively small beam and fast scanning gave challenges to the characterization, a secondary purpose was to develop and apply new approaches where necessary to do so.
  
  
  METHODS
  The following performances of the proton scanning systems were investigated: beamlet alignment, static in-air beamlet size and shape, scanned in-air penumbra, scanned fluence map accuracy, geometric alignment of scanning system to isocenter, maximum field size, lateral and longitudinal field uniformity of a 1 l cubic uniform field, output stability over time, gantry angle invariance, monitoring system linearity, and reproducibility. A range of detectors was used: film, ionization chambers, lateral multielement and longitudinal multilayer ionization chambers, and a scintillation screen combined with a digital video camera. Characterization of the scanned fluence maps was performed with a software analysis tool.
  
  
  RESULTS
  The resulting measurements and analysis indicated that the two types of delivery systems performed within specification for those aspects investigated. The significant differences were observed between the two types of scanning systems where one type exhibits a smaller spot size and associated penumbra than the other. The differential is minimum at maximum energy and increases inversely with decreasing energy. Additionally, the large spot system showed an increase in dose precision to a static target with layer rescanning whereas the small spot system did not.
  
  
  CONCLUSIONS
  The measured results from the two types of modulated scanning types of system were consistent with their designs under the conditions tested. The most significant difference between the types of system was their proton spot size and associated resolution, factors of magnetic optics, and vacuum length. The need and benefit of mutielement detectors and high-resolution sensors was also shown. The use of a fluence map analytical software tool was particularly effective in characterizing the dynamic proton energy-layer scanning.
authors.affiliation: Westdeutsches Protonentherapiezentrum Essen, Universitätsklinikum-Essen, Hufelandstrasse 55, 45147 Essen, Germany. jonathan.farr@stjude.org
authors.forename: J B
authors.initials: JB
authors.lastname: Farr
authors.forename: F
authors.initials: F
authors.lastname: Dessy
authors.forename: O
authors.initials: O
authors.lastname: De Wilde
authors.forename: O
authors.initials: O
authors.lastname: Bietzer
authors.forename: D
authors.initials: D
authors.lastname: Schönenberg
mesh_terms: D004867:Equipment Design; D061766:Proton Therapy / Q000295:instrumentation*; D011786:Quality Control